| NPI | 1952588741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M KELLOGG Dentist 517-546-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI 13543) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-01-24 |